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PHLEBITIS AND INFILTRATION STATUS İN PERIPHERAL INTRAVENOUS CATHETERISATION INCHILDREN

Yıl 2014, Cilt: 30 Sayı: 2, 40 - 54, 01.06.2014

Öz

Objective: Periferal intravenous catheters can cause local comlications such as phlebitis and infiltration. Phlebitis and infiltration needs catheter removal and replacement. Routinely replacement o f intravenous catheters in childrens is not recommended. A descriptive study was performed to examine the status o f phlebitis and infiltration associated with peripheral intravenous catheterisation.Methods: Children n=74 hospitalized in pediatric clinic betvveen 3-18years were included to the study. The catheterisation sites examined daily by one o f the investigator for the presence and severity o f phlebitis and infiltration using a scale. Local research ethics committee approved the study and written informed consent was obtained from parents o f children. Patients those who were immunocompromised and those receiving chemotherapy were excluded from the study. Data were collected betvveen the date o f 18 December 2010- 26 th January 2012. Numerical and percentage distribution, Chi-square test and correlation were used in analysis o f the data.Results: The mean age o f children was 8.29 ± 3.83 year. Mean dwell time for catheters in situ in our study were 3-303 hours. The mean catheterisation time was 83.52 ± 56.44 hours. Corticosteroids have been given to 64.9% o f the patients and 40.5% o f the patients have been given drugs or fluids İV 1/3 izomiks with a set o f the pump. The phlebitis in 45.9% o f patients was occured, and the infiltration was occured in 54.1% ofpatient. The severity o f phlebitis in 23% o f patients was in 3 degree, and the severity o f infiltration in 20.3% o f patients was in 1 degree. Catheters wer removed in 45.9% o f patients because o f discontinuation o f treatment and in 4.1 % because o f occlusion o f catheters. The rate o f patients that developed infiltration was significantly more in patients in whom a catheter was inserted in pediatric clinic. The percentage o f patients that developed infiltration and phlebitis was significantly more in patients in whom the same area have been used repeatedly for insertion o f a catheter.Conclusion: it was found that the rate for phlebitis and infiltration were high. Future studies with large samples should implemented both in general pediatric units and in pediatric intensive çare unit

Kaynakça

  • Bakır M ve Soysal A. Pediatride İntravasküler Katetere Bağlı Enfeksiyonlar. Pediatride Nazokomiyal Enfeksiyonlar. 1. Baskı. Ankara: Bilimsel Tıp Yayınevi; 2003. 59-74.
  • Bernaerts K, Evers G, Sermeus W . Frequency of intravenous Medication Administration T o Hospitalised Patients: Secondary Data-Analysis of the Belgian Nursing Minimum Data Set. International Journal of Nursing Studies 2000; (37): 101-110.
  • Bowcutt M, Rosenkoetter MM , Chernecky CC, W all J, Wynn D, Serrano C. Implementation of an intravenous Medication İnfusion Pump System: İmplications For Nursing, Journal of Nursing Management 2008; (16): 188-197.
  • Catney M R, Hillis S, Wakefield B, Simpson L, Domino L, Keller S, Connelly T , W hite M, Price D. Wagner K. Relationship Between Peripheral intravenous Catheter Dwell Time and the Development of Phlebitis and infiltration, Journal of infusion Nursing 2001; 2 4(5): 332- 341.
  • Chang KK, Chung JW , Wong T K , Learning intravenous Cannulation: a Comparison of the Conventional Method and the CathSim intravenous Training System, Journal of Clinical Nursing 2002; (11): 73-78.
  • Couzigou C, Lamory J, Ceron S.D ve ark Short peripheral venous catheters: effect of evidence-based guidelines on insertion, maintenance and outcomes in a university hospital. Journal of Hospital infection 2005; (59): 197-204.
  • Curan E .T, Coia J.E, Gilmour H ve ark. Multi-centre Research Surveillance Project to Reduce infections/phlebitis Associated with Peripheral Vascular Ccatheters, Journal of Hospital infection 2000; (46): 194-202.
  • Çökmez A, Çökmez A, Gür S, Genç H, Deniz S, Tarcan E. Effect of Transdermal Glyceryl Trinitrate And Anti-inflammatory Gel On infusion Phlebitis, ANZ J. Surg 2003; 7 9 4 -7 9 6 .
  • Doeliman D, Hadaway L, Bowe-Geddes LA, Franklin M, LeDonne J, Papke-O’Donnell, Pettit J, Schulmeister L, Stranz M . infiltration and Extravasation 2009; 3 2(4): 203-211.
  • Fujita T and Namiki N. Replacement of Peripheral intravenous Catheters. Journal of Clinical Nursing 2008. (17): 2509-2510.
  • Groll D, Davies B, Mac Donald J, Nelson S, Virani T . Evaluation of the Psychometric Properties of The Phlebitis And infiltration Scales For The Assessment of Complications of Peripheral Vascular Access Devices. J infus Nurs 2010; 33(6): 385-90.
  • Gupta P, Ruchi R , Basu S, Faridi M . Life Span of Peripheral intravenous Cannula in a Neonatal intensive Care Unit of a Developing Country. Journal of Pediatric Nursing 2003;18(4): 287-292.
  • infusion nursing standards of practice. Journal of intravenous Nursing November/December 2000; 23(6): 1-88.
  • Karadağ A. Ven içi sıvı tedavisi: komplikasyonlar ve hemşirelik bakımı, C.Ü. Hemşirelik Yüksekokulu Dergisi 1999; 3(1): 39-47.
  • Karagözoğlu Ş.A. İntravenöz Sıvı Tedavisi Komplikasyonu Olarak Gelişen Tromboflebitte Hemşirelik Bakımı ve Sıcak-Soğuk Uygulamanın Yeri, C.Ü. Hemşirelik Yüksekokulu Dergisi 2001; 5 (1): 18-25.
  • Lai KK. Safety of prolonging peripheral cannula and iV tubing use from 72 hours to 96 hours. A JiC Am J infect Control 1998; 25(1): 66-70.
  • Lopez V, Malassiotis A, Chan W K, Ng F, Wong E. A n intervention Study to Evaluate Nursing Management of Peripheral intravascular Devices, Journal of infusion Nursing 2004; 2 7(5): 322-331.
  • Lundgren A, Ek A .C ve Wahren L Handling and Control of Peripheral intravenous Lines. Journal of Advenced Nursing 1998; (27): 897-904.
  • Lundgren A, W ahren LK. Effect of Education on Eevidence-based Care and Handling of Peripheral Ntravenous Lines. Journal of Clinical Nursing 1999; (8): 577-585.
  • Myrianthefs P, Sifaki M , Samara i and Baltopoulos G. The Epidemiology of Peripheral Vein Complications: Evaluation of The Efficiency of Differing Methods For The Maintenance of Catheter Patency And Thrombophlebitis Prevention. Journal of Evaluation in Clinical Practice 2005; 11(1): 85­ 89.
  • Oishi LA. Necessity of Routinely Replacing Peripheral intravenous Catheters in Hospitalized Children, Journal of intravenous Nursing 2001; 24(3): 174-178.
  • Panadero A, iohom G, T aj J, Mackay N, Shorten G. A dedicated intravenous Cannula for Postoperative Use Effect on incidence and Severity 20 0 2 ;(5 7 ): 921-925.
  • Rickard CM, Webster J, Wallis M C, Marsh N, McGrail M R, French V , Foster L, Gallagher P, Gowardman JR , Zhang L, McClymont A , Whitby M.Routine versus clinical replacement of peripheral intravenous Catheters: a Randomized Ccontrolled Equivalence Trial. www.thelancet 2012; 380, September 22, 1066-1074.
  • Shimandle R .B, Johnson D, Baker M ve ark. Safety of Peripheral intravenous Catheters in Children. infection Control and Hospital Epidemiology 1999; 20(11): 7 3 6 -7 4 0 .
  • Şelimen D, Eti Aslan F, Gürkan A, Zora A. İntravenöz kateterlerin Damardan Çıkarılma Nedenleri, Hemşirelik Forumu 2002; 5(2): 22-26.
  • Tagarakis V, Kahn S, Libman M , Blostein M. The Epidemiology of Peripheral Vein infusion Thrombophlebitis: a Critical Review. American Journal of Medicine 2002; 113: 46-151.
  • Uslusoy E ve Mete S. Predisposing factors to Phlebitis in Patients W ith Peripheral intravenous Catheters: a Descriptive Study. Journal of the American Academy of Nurse Practitioners 2008; 20: 172-180.
  • Webster J, Lloyd S, Hopkins T ve ark. Developing a Research Base for intravenous Peripheral Cannula re- sites (D RiP trial). A Randomised Controlled Trial of Hospital in-Patients. international Journal of Nursing Studies 2007; 44: 664-671.
  • Vries JH, Dorp W T , Barneveld PW C. A Randomized Trial of Alcohol 70% Versus Alcoholic iodine 2% in Skin Disinfection Before insertion of Pperipheral infusionCcatheters. Journal of Hospital infection, 1997; 36: 317-320.

ÇOCUKLARDA PERİFERİK İNTRAVENÖZ KATETER UYGULAMALARINDA FLEBİT VE İNFİLTRASYON GELİŞME DURUMU

Yıl 2014, Cilt: 30 Sayı: 2, 40 - 54, 01.06.2014

Öz

Amaç: Periferal intravenöz kateterler flebit ve infiltrasyon gibi lokal komplikasyonlara neden olabilirler. Flebit ve infiltrasyon kateterin çıkarılmasını ve tekrar takılmasını gerektirir. Çocuklarda önerilmemektedir. Periferal intravenöz kateterlere bağlı flebit ve infiltrasyon görülme durumunu belirlemek amacıyla tanımlayıcı bir çalışma yapıldı.Gereç ve Yöntem: Hastaneye yatırılan 3-18 yaş grubundaki hastalar n= 74 çalışma kapsamına alındı. Kateterizasyon bölgesi her gün araştırmacılardan biri tarafından, infiltrasyon ve flebit gelişme ile şiddeti açısından kontrol edildi. Yerel araştırma komitesi çalışmayı onayladı, çocukların ebeveynlerinden yazılı onam alındı. Bağışıklığı baskılanmış olan ve kemoterapi alan hastalar çalışma kapsamına alınmadı. Veriler 18 Aralık 2010- 26 Ocak 2012 tarihleri arasında toplandı. Verilerin analizinde sayısal ve yüzdelik dağılım, ki-kare ve korelasyon testi kullanıldı.Bulgular: Çocukların yaş ortalaması 8.29 + 3.83 yıldı. Çalışmamızda kateterler 3-303 saat yerinde bırakıldı. Kateterizasyon süre ortalaması 83.52 + 56.44 saat idi. Hastaların %64.9' una takılan İV kateterden kortikosteroid türü ilaç, %40.5'ine 1/3 izomiks, %58.1'ine pump seti kullanılarak sıvı veya ilaç verilmekteydi. Hastaların %54.1'inde ise infiltrasyon geliştiği, %45.9'ünde flebit geliştiği saptandı. Hastaların %23'ünde 3. derecede flebit, %20.3'ünde ise 1. derecede infiltrasyon gelişmiştir. Hastaların %45.9'unda tedavi sonlandırıldığı için, %4.1'inde kateter tıkandığı için kateter çıkarılmıştır. Kateterleri pediatri kliniğinde takılan hastalarda infiltrasyon oranı daha yüksekti. Aynı bölgeye defalarca kateter takılan hastalarda flebit ve infiltrasyon oranı daha yüksekti.Sonuç: Flebit ve infiltrasyon oranının yüksek olduğu bulundu. Daha geniş bir örneklemde, pediatri ve pediatrik yoğun bakım ünitelerini de kapsayacak şekilde ileri araştırmalar yapılmalıdır

Kaynakça

  • Bakır M ve Soysal A. Pediatride İntravasküler Katetere Bağlı Enfeksiyonlar. Pediatride Nazokomiyal Enfeksiyonlar. 1. Baskı. Ankara: Bilimsel Tıp Yayınevi; 2003. 59-74.
  • Bernaerts K, Evers G, Sermeus W . Frequency of intravenous Medication Administration T o Hospitalised Patients: Secondary Data-Analysis of the Belgian Nursing Minimum Data Set. International Journal of Nursing Studies 2000; (37): 101-110.
  • Bowcutt M, Rosenkoetter MM , Chernecky CC, W all J, Wynn D, Serrano C. Implementation of an intravenous Medication İnfusion Pump System: İmplications For Nursing, Journal of Nursing Management 2008; (16): 188-197.
  • Catney M R, Hillis S, Wakefield B, Simpson L, Domino L, Keller S, Connelly T , W hite M, Price D. Wagner K. Relationship Between Peripheral intravenous Catheter Dwell Time and the Development of Phlebitis and infiltration, Journal of infusion Nursing 2001; 2 4(5): 332- 341.
  • Chang KK, Chung JW , Wong T K , Learning intravenous Cannulation: a Comparison of the Conventional Method and the CathSim intravenous Training System, Journal of Clinical Nursing 2002; (11): 73-78.
  • Couzigou C, Lamory J, Ceron S.D ve ark Short peripheral venous catheters: effect of evidence-based guidelines on insertion, maintenance and outcomes in a university hospital. Journal of Hospital infection 2005; (59): 197-204.
  • Curan E .T, Coia J.E, Gilmour H ve ark. Multi-centre Research Surveillance Project to Reduce infections/phlebitis Associated with Peripheral Vascular Ccatheters, Journal of Hospital infection 2000; (46): 194-202.
  • Çökmez A, Çökmez A, Gür S, Genç H, Deniz S, Tarcan E. Effect of Transdermal Glyceryl Trinitrate And Anti-inflammatory Gel On infusion Phlebitis, ANZ J. Surg 2003; 7 9 4 -7 9 6 .
  • Doeliman D, Hadaway L, Bowe-Geddes LA, Franklin M, LeDonne J, Papke-O’Donnell, Pettit J, Schulmeister L, Stranz M . infiltration and Extravasation 2009; 3 2(4): 203-211.
  • Fujita T and Namiki N. Replacement of Peripheral intravenous Catheters. Journal of Clinical Nursing 2008. (17): 2509-2510.
  • Groll D, Davies B, Mac Donald J, Nelson S, Virani T . Evaluation of the Psychometric Properties of The Phlebitis And infiltration Scales For The Assessment of Complications of Peripheral Vascular Access Devices. J infus Nurs 2010; 33(6): 385-90.
  • Gupta P, Ruchi R , Basu S, Faridi M . Life Span of Peripheral intravenous Cannula in a Neonatal intensive Care Unit of a Developing Country. Journal of Pediatric Nursing 2003;18(4): 287-292.
  • infusion nursing standards of practice. Journal of intravenous Nursing November/December 2000; 23(6): 1-88.
  • Karadağ A. Ven içi sıvı tedavisi: komplikasyonlar ve hemşirelik bakımı, C.Ü. Hemşirelik Yüksekokulu Dergisi 1999; 3(1): 39-47.
  • Karagözoğlu Ş.A. İntravenöz Sıvı Tedavisi Komplikasyonu Olarak Gelişen Tromboflebitte Hemşirelik Bakımı ve Sıcak-Soğuk Uygulamanın Yeri, C.Ü. Hemşirelik Yüksekokulu Dergisi 2001; 5 (1): 18-25.
  • Lai KK. Safety of prolonging peripheral cannula and iV tubing use from 72 hours to 96 hours. A JiC Am J infect Control 1998; 25(1): 66-70.
  • Lopez V, Malassiotis A, Chan W K, Ng F, Wong E. A n intervention Study to Evaluate Nursing Management of Peripheral intravascular Devices, Journal of infusion Nursing 2004; 2 7(5): 322-331.
  • Lundgren A, Ek A .C ve Wahren L Handling and Control of Peripheral intravenous Lines. Journal of Advenced Nursing 1998; (27): 897-904.
  • Lundgren A, W ahren LK. Effect of Education on Eevidence-based Care and Handling of Peripheral Ntravenous Lines. Journal of Clinical Nursing 1999; (8): 577-585.
  • Myrianthefs P, Sifaki M , Samara i and Baltopoulos G. The Epidemiology of Peripheral Vein Complications: Evaluation of The Efficiency of Differing Methods For The Maintenance of Catheter Patency And Thrombophlebitis Prevention. Journal of Evaluation in Clinical Practice 2005; 11(1): 85­ 89.
  • Oishi LA. Necessity of Routinely Replacing Peripheral intravenous Catheters in Hospitalized Children, Journal of intravenous Nursing 2001; 24(3): 174-178.
  • Panadero A, iohom G, T aj J, Mackay N, Shorten G. A dedicated intravenous Cannula for Postoperative Use Effect on incidence and Severity 20 0 2 ;(5 7 ): 921-925.
  • Rickard CM, Webster J, Wallis M C, Marsh N, McGrail M R, French V , Foster L, Gallagher P, Gowardman JR , Zhang L, McClymont A , Whitby M.Routine versus clinical replacement of peripheral intravenous Catheters: a Randomized Ccontrolled Equivalence Trial. www.thelancet 2012; 380, September 22, 1066-1074.
  • Shimandle R .B, Johnson D, Baker M ve ark. Safety of Peripheral intravenous Catheters in Children. infection Control and Hospital Epidemiology 1999; 20(11): 7 3 6 -7 4 0 .
  • Şelimen D, Eti Aslan F, Gürkan A, Zora A. İntravenöz kateterlerin Damardan Çıkarılma Nedenleri, Hemşirelik Forumu 2002; 5(2): 22-26.
  • Tagarakis V, Kahn S, Libman M , Blostein M. The Epidemiology of Peripheral Vein infusion Thrombophlebitis: a Critical Review. American Journal of Medicine 2002; 113: 46-151.
  • Uslusoy E ve Mete S. Predisposing factors to Phlebitis in Patients W ith Peripheral intravenous Catheters: a Descriptive Study. Journal of the American Academy of Nurse Practitioners 2008; 20: 172-180.
  • Webster J, Lloyd S, Hopkins T ve ark. Developing a Research Base for intravenous Peripheral Cannula re- sites (D RiP trial). A Randomised Controlled Trial of Hospital in-Patients. international Journal of Nursing Studies 2007; 44: 664-671.
  • Vries JH, Dorp W T , Barneveld PW C. A Randomized Trial of Alcohol 70% Versus Alcoholic iodine 2% in Skin Disinfection Before insertion of Pperipheral infusionCcatheters. Journal of Hospital infection, 1997; 36: 317-320.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Özgün Araştırma
Yazarlar

Sevil Olgun Bu kişi benim

Ayşe Demiray Bu kişi benim

İsmet Eşer Bu kişi benim

Leyla Khorshıd Bu kişi benim

Yayımlanma Tarihi 1 Haziran 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 30 Sayı: 2

Kaynak Göster

APA Olgun, S., Demiray, A., Eşer, İ., Khorshıd, L. (2014). ÇOCUKLARDA PERİFERİK İNTRAVENÖZ KATETER UYGULAMALARINDA FLEBİT VE İNFİLTRASYON GELİŞME DURUMU. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 30(2), 40-54.